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Chemotherapy scandal: Pharmacy staff who caught error to testifyPharmacy assistants from Peterborough hospital who caught error of diluted doses of chemotherapy for Canadian cancer patients will testify before Ontario committee.

Michael Blanchard, left, vice-president of pharmacy for Medbuy, and Kent Nicholson, president and chief executive officer, testify Monday at Queen's Park. Medbuy is the company that procured chemotherapy drugs for five Ontario hospitals, later found to be diluted. (TARA WALTON / TORONTO STAR)

By Diana Zlomislic and Tim AlamenciakStaff Reporters

Mon., May 6, 2013

For the first time the public will hear Tuesday afternoon how a team of Peterborough pharmacy assistants uncovered a chemotherapy medication error that went undetected at four other hospitals for more than a year.

Craig Woudsma and Judy Turner, two of the three assistants who first spotted the error, will testify before the Queen’s Park social policy committee investigating the diluted chemotherapy scandal.

The committee has been calling up key players to fill in details on how 1,205 Canadian cancer patients came to receive weaker-than-prescribed doses of chemotherapy medication.

During Monday’s testimony, officials for Medbuy, which brokered the deals for affected hospitals, told committee members Marchese Hospital Solutions did not meet the requirements of its contract.

“The problem is that the labels do not accurately describe the contents of the bag,” Michael Blanchard, Medbuy’s vice-president of pharmacy, told the provincial committee that is investigating the drug error.

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Since the scandal broke early last month, Marchese, a relatively new player in the growing and unregulated business of outsourced pharmacy services, has insisted it fulfilled the terms of its contract, which started last February.

Medbuy’s top executives disagree.

The hospitals, they said, relied on the products being made a certain way and that’s not what happened.

As a group purchaser, Medbuy negotiated the chemo contracts for hospitals and vetted three contenders including Marchese.

Marchese Hospital Solutions, “did not ask a sufficient number of questions,” said Nicholson. “There was an onus for them to understand in absolute terms how this product was administered,” he said.

A total of 1,205 patients at four hospitals in Ontario and one in New Brunswick received the diluted drugs. One-hundred-and-fifty of those patients have died since the treatments began in February 2012. It’s unknown what, if any, role the diluted chemotherapy played in their deaths.

Pharmacists must mix the drug, which comes in a powder form, with saline so it can be administered to patients. The bags of saline, which are purchased by companies like Marchese through another supplier, are typically overfilled to account for evaporation. Pharmacists have to account for this overfill when mixing the drugs. Marchese did not, the committee heard.

Marita Zaffiro, president of Marchese Hospital Solutions, testified previously that her company had been producing the bags as though a patient would receive the entire contents, making dilution a non-issue.

The bags contained 4 grams of the cancer-fighting drugs, an amount “that would be a harmful dose to a single patient,” Blanchard said.

A Toronto Star investigation last month revealed that Marchese Hospital Solutions was part of a growing industry operating without federal or provincial oversight. While government policing applies to drug manufacturers and pharmacies, triggering regular inspections and compliance with quality assurance rules, no such protocols exist for companies like Marchese Hospital Solutions.

“This was an acceptable practice in the community,” Blanchard testified. “Health Canada and the College of Pharmacists were well aware of this practice.”

Medbuy said it has notified Marchese that it is in breach of contract. Marchese declined comment.

The Ontario College of Pharmacists is holding a special meeting Friday to pass regulations that would empower it to inspect premises where licensed pharmacists or pharmacy technicians work even if the facility is not an accredited pharmacy. The regulations would trigger inspections at sites that would otherwise fall into an oversight gap.

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